Tailored interventions for Alzheimer’s disease more beneficial for women

The results of a new study by researchers at Florida Atlantic University in the US report that women may gain more benefit than men from individually tailored clinical interventions to prevent or treat Alzheimer’s disease (AD).

Alzheimer’s is a degenerative brain disease and the most common cause of dementia, and is also associated with cardiovascular conditions. The disease is characterised by the presence of amyloid plaque deposits and neurofibrillary tangles in the brain, along with brain shrinkage caused by the death of neurons. There is no known cure, but some medications and lifestyle changes can improve symptoms, especially in the earlier stages of disease.

Illustration showing neurons with neurofibrillary tangles and amyloid plaques in the brain of a patient with alzheimer's disease
Illustration depicting typical features of Alzheimer’s disease such as amyloid plaques and neurons containing neurofibrillary tangles. Credit: Kateryna Kon / Science Photo Library / Getty Images.

Alzheimer’s is estimated to affect up to one in 10 Australians over the age of 65, increasing to three in 10 over the age of 85.

While age is the biggest known risk factor for developing Alzheimer’s disease, sex is next on the list. About two-thirds of Alzheimer’s patients are female, and women are at a higher risk of developing Alzheimer’s, even after accounting for the fact that they tend to live longer than men. This has led to calls to factor sex and gender more explicitly into Alzheimer’s research. 

“Our findings are important because women are disproportionately affected by Alzheimer’s disease,” says Richard S. Isaacson, a medical doctor and neurology researcher at Florida Atlantic University.

“Population-attributable risk models suggest that managing risk factors can prevent up to one-third of dementia cases, highlighting the immense potential that lies in addressing modifiable risk factors.”

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The paper led by Isaacson used data from a clinical trial of an individually tailored, multi-domain intervention in patients who had no noticeable cognitive decline (the “prevention” group) and with mild Alzheimer’s disease (the “early treatment” group). The intervention included recommendations for patient education, medications, counselling, and cognitive engagement, which were tailored to each patient based on their clinical history and medical assessments.

Looking at 80 participants across both groups, the study found that the treatment was associated with improved cognition in both women and men. However, women in the prevention group experienced greater improvements to their risk of atherosclerosis comparted with men, while women in the early treatment group also experienced greater improvements in scores measuring both cardiovascular and late-life dementia risk.

Alzheimer's disease in women concept a white male doctor in a lab coat examining a blonde woman in a medical office
Richard Isaacson examining a patient. Credit: Alex Dolce, Florida Atlantic University.

“While care in an Alzheimer’s Prevention Clinic setting is equally effective at improving cognitive function in both women and men, our personally tailored interventions led to greater improvements in women compared to men across Alzheimer’s and cardiovascular disease risk scales, as well blood biomarkers of risk such as blood sugar, LDL cholesterol, and the diabetes test HbA1C,” summarises Isaacson.

“Our work also highlights the need for larger studies focusing on sex differences in AD-related cognitive trajectories, as the existing body of knowledge lacks conclusive evidence on this issue,” he adds.

The study was supported by funding from the Women’s Alzheimer’s Movement as well as other philanthropic and government sources.

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